Parental risk factors associated with congenital heart disease in a Thai population: multivariable analysis

Characteristic	Case (n = 249) n (%)	Control (n = 304) n (%)	P
Sex^†			0.033
Male	124 (49.8)	179 (58.9)
Female	125 (50.2)	125 (41.1)
Age^† (years)			<0.001
<1	50 (20.1)	71 (23.4)
1–5	86 (34.5)	165 (54.2)
6–10	63 (25.3)	47 (15.5)
>10	50 (20.1)	21 (6.9)
Gravida			0.29
Primigravida	112 (45.0)	123 (40.5)
Multigravida	137 (55.0)	181 (59.5)
Parity			0.67
1	118 (47.4)	140 (46.0)
2	101 (40.6)	133 (43.8)
3 or more	30 (12.0)	31 (10.2)
History of abortion^‡			0.050
None	220 (88.4)	252 (82.9)
1	27 (10.8)	41 (13.5)
2 or more	2 (0.8)	11 (3.6)
Gestational weeks^‡			0.02
<34	0 (0)	8 (2.6)
34–36	26 (10.4)	36 (11.8)
≥ 37	223 (89.6)	260 (85.5)

† χ² test

‡ Fisher exact test.

CHD, congenital heart disease.

Table 2

Diagnosis of congenital heart disease.

Diagnosis	n = 249 (%)
Less severe	155 (62.2)
VSD	69 (27.7)
ASD	41 (16.5)
PDA	22 (8.8)
Pulmonary stenosis	20 (8.0)
Aortic stenosis	1 (0.4)
Aortic regurgitation	1 (0.4)
Coarctation of aorta	1 (0.4)
Severe	94 (37.8)
TOF	35 (14.0)
Double outlet of right ventricle	13 (5.2)
Single ventricle	11 (4.4)
Pulmonary atresia with VSD	8 (3.2)
Ebstein anomaly	7 (2.8)
Transposition of the great vessels	7 (2.8)
Pulmonary atresia with intact ventricular septum	4 (1.6)
Atrioventricular canal defect	4 (1.6)
Tricuspid atresia	3 (1.2)
Anomalous left coronary artery from the pulmonary artery	1 (0.4)
TAPVR	1 (0.4)

[i] ASD, atrial septal defect; PDA, patent ductus arteriosus; TOF, tetralogy of Fallot; TAPVR, total anomalous pulmonary venous return; VSD, ventricular septal defect.

Table 3

Familial biological data as a risk of CHDs on univariate analysis.

Characteristic	Case (n = 249) n (%)	Control (n = 304) n (%)	OR	95% CI	P
Family history of congenital heart disease					0.001^*
Yes	21 (8.4)	6 (2.0)	4.58	1.82–11.52
No	228 (91.6)	298 (98.0)	1.00	Ref.
Maternal age (years)					0.67
<20	26 (10.4)	27 (8.9)	1.00	Ref.
20–35	183 (73.5)	221 (72.7)	0.86	0.49–1.53
≥ 35	40 (16.1)	56 (18.4)	0.74	0.38–1.46
Paternal age (years)					0.84
<20	11 (4.4)	16 (5.3)	1.00	Ref.
20–35	164 (65.9)	194 (63.8)	1.23	0.56–2.72
≥ 35	74 (29.7)	94 (30.9)	1.15	0.50–2.62
Maternal pregnancy complication
GDM					0.013^*
Yes	11 (4.4)	31 (10.2)	0.41	0.20–0.83
No	238 (95.6)	273 (89.8)	1.00	Ref.
Pregnancy-induced hypertension					0.11
Yes	8 (3.2)	19 (6.3)	0.50	0.21–1.16
No	241 (96.8)	285 (93.7)	1.00	Ref.

* P < 0.05, significant.

CHDs, congenital heart diseases; CI, confidence interval; GDM, gestational DM; Ref. reference; OR, odds ratio.

Table 4

Parental environmental hazard exposure on univariate analysis.

Characteristics	Case (n = 249) n (%)	Control (n = 304) n (%)	OR	95% CI	P
Maternal smoking					0.11
Yes	6 (2.4)	2 (0.7)	3.73	0.75–18.64
No	243 (97.6)	302 (99.3)	1.00	Ref.
Maternal exposure to second-hand smoke					<0.001^*
Yes	151 (60.6)	121 (39.8)	2.33	1.65–3.28
No	98 (39.4)	183 (60.2)	1.00	Ref.
Paternal smoking					0.002^*
Yes	134 (53.8)	124 (40.8)	1.69	1.21–2.37
No	115 (46.2)	180 (59.2)	1.00	Ref.
Maternal alcohol drinking					0.98
Yes	16 (6.5)	20 (6.6)	0.98	0.50–1.93
No	232 (93.5)	284 (93.4)	1.00	Ref.
Paternal alcohol drinking					0.036^*
Yes	176 (70.7)	189 (62.2)	1.47	1.03–2.10
No	73 (29.3)	115 (37.8)	1.00	Ref.
History of pesticide exposure					<0.001^*
Yes	57 (22.9)	23 (7.6)	3.63	2.16–6.09
No	192 (77.1)	281 (92.4)	1.00	Ref.
History of chemical exposure					0.53
Yes	5 (2.0)	4 (1.3)	1.54	0.41–5.79
No	244 (98.0)	300 (98.7)	1.00	Ref.
History of paint exposure					0.38
Yes	12 (4.8)	20 (6.6)	0.72	0.34–1.50
No	237 (95.2)	284 (93.4)	1.00	Ref.

* P < 0.05; Ref. reference; Case, case of congenital heart disease; Control, patient control.

CI, confidence interval; OR, odds ratio.

Table 5

Parental socioeconomic status univariate analysis.

Characteristic	Case (n = 249) n (%)	Control (n = 304) n (%)	OR	95% CI	P
Occupation					<0.001^*
Farmer	38 (15.3)	9 (3.0)	2.35	0.63–8.72
Manual worker	33 (13.3)	11 (3.6)	1.67	0.46–6.05
Merchant/self-employed	30 (12.0)	42 (13.8)	0.40	0.12–1.30
Employee	74 (29.7)	80 (26.3)	0.51	0.17–1.60
Government officer	22 (8.8)	90 (29.7)	0.14	0.04–0.45
Housekeeper	43 (17.3)	67 (22.0)	0.36	0.114–1.14
Student	9 (3.6)	5 (1.6)	1.00	Ref.
Maternal educational attainment					<0.001^*
Primary school or lower	52 (20.9)	27 (8.9)	1.00	Ref.
Junior high school	56 (22.5)	37 (12.2)	0.79	0.42–1.47
High school	87 (34.9)	92 (30.3)	0.49	0.28–0.85
Bachelor degree or higher	54 (21.7)	148 (48.6)	0.19	0.11–0.33
Family income per month baht (USD)^†					<0.001^*
<10,000 (<322)	55 (22.1)	44 (14.5)	1.00	Ref.
10,000–30,000 (322–966)	152 (61.1)	138 (45.4)	0.88	0.56–1.39
30,001–50,000 (966–1611)	25 (10.0)	76 (25.0)	0.26	0.14–0.48
>50,000 (>1611)	17 (6.8)	46 (15.1)	0.30	0.15–0.59

Case, patient with congenital heart disease; Control, patient control.

* P < 0.05.

† U.S. Federal Reserve G.5A annual foreign exchange rates for 2019 available from: https://www.federalreserve.gov/releases/g5a/current/

CI, confidence interval; OR, odds ratio; SES, socioeconomic status.

Table 6

Parental risk factors for CHDs on multiple logistic regression.

Factor	Case (n = 249) n (%)	Control (n = 304) n (%)	AOR	95% CI	P
Family history of congenital heart disease					0.005^*
Yes	21 (8.4)	6 (2.0)	4.67	1.61–13.57
No	228 (91.6)	298 (98.0)	1.00	Ref.
Maternal exposure to second-hand smoke					0.002^*
Yes	151 (60.6)	121 (39.8)	1.58	1.03–2.42
No	98 (39.4)	183 (60.2)	1.00	Ref.
GDM
Yes	11 (4.4)	31 (10.2)	0.60	0.27–1.33	0.21
No	238 (95.6)	273 (89.8)	1.00	Ref.
Paternal smoking					0.12
Yes	134 (53.8)	124 (40.8)	1.45	0.23–2.88
No	115 (46.2)	180 (59.2)	1.00	Ref.
Paternal alcohol drinking					0.16
Yes	176 (70.7)	189 (62.2)	1.38	0.88–2.16
No	73 (29.3)	115 (37.8)	1.00	Ref.
History of pesticide exposure					0.11
Yes	57 (22.9)	23 (7.6)	1.88	0.87–4.05
No	192 (77.1)	281 (92.4)	1.00	Ref.
Occupation					0.64
Farmer	38 (15.3)	9 (3.0)	0.68	0.14–3.32
Manual worker	33 (13.3)	11 (3.6)	1.32	0.32–5.50
Merchant/Self-employed	30 (12.0)	42 (13.8)	0.32	0.09–1.22
Employee	74 (29.7)	80 (26.3)	0.43	0.18–1.56
Government officer	22 (8.8)	90 (29.7)	0.16	0.04–0.64
Housekeeper	43 (17.3)	67 (22.0)	0.24	0.07–0.89
Student	9 (3.6)	5 (1.6)	1.00	Ref.
Maternal educational attainment					0.50
Primary school or lower	52 (20.9)	27 (8.9)	1.00	Ref.
Junior high school	56 (22.5)	37 (12.2)	1.58	0.71–3.56
High school	87 (34.9)	92 (30.3)	1.59	0.78–3.26
Bachelor degree or higher	54 (21.7)	148 (48.6)	1.13	0.63–2.03
Family income per month baht (USD)^†					0.53
<10,000 (323)	55 (22.1)	44 (14.5)	1.00	Ref.
10,000–30,000 (323–996) USD)	152 (61.1)	138 (45.4)	1.08	0.43–2.70
30,001–50,000 (996–1610)	25 (10.0)	76 (25.0)	1.40	0.65–3.00
>50,000 baht (>1610)	17 (6.8)	46 (15.1)	0.96	0.43–2.12

* P < 0.05.

† U.S. Federal Reserve G.5A annual foreign exchange rates for 2019 available from: https://www.federalreserve.gov/releases/g5a/current/

AOR, adjusted odds ratio; CHDs, congenital heart diseases; CI, confidence interval; GDM, gestational DM.

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DOI: https://doi.org/10.2478/abm-2021-0033 | Journal eISSN: 1875-855X | Journal ISSN: 1905-7415

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Language: English

Page range: 267 - 276

Published on: Dec 30, 2021

Published by: Chulalongkorn University

In partnership with: Paradigm Publishing Services

Keywords:

heart defects, congenital,

heart disease risk factors,

pregnancy,

smoking,

Thailand

Related subjects:

Medicine,

Assistive professions, nursing,

Basic medical science,

Basic medical science, other,

Clinical medicine,

Clinical medicine, other

© 2021 Chayamon Suwansumrit, Worawan Jittham, published by Chulalongkorn University
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 15 (2021): Issue 6 (December 2021)

Parental risk factors associated with congenital heart disease in a Thai population: multivariable analysis

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